Fraud is surprisingly widespread across the healthcare industry in the United States – and the rest of the world, for that matter. Sometimes, it can take place as a result of human error; however, in many cases, the fraudulent activity is a purposeful action. Often, these actions might seem harmless at the time, but the reality is that they have the potential to put your medical practice at severe risk in the long run. In short, it is better to be safe than sorry!
Here is a guide to avoiding making any missteps that could prove costly to your bank account and your reputation further down the line.
Be mindful about all billing-related concerns
Ensuring that your billing process is up to scratch is vital in avoiding fraud. One of the most common types of Medicare frauds as of 2020 is phantom billing, which essentially relates to billing for a procedure that was never actually performed, or billing for something more complex than what actually took place. Along with phantom billing, be sure to watch out for double billing, which occurs when a physician (accidentally or purposefully) bills the patient, Medicare, or the patient’s insurance company twice.
Take the time to double check all billing before submitting them or invest in medical billing software for maximum peace of mind.
Do your best to keep procedures affordable for your patients
Many medical professionals will go in search of a Medicare fraud attorney in Charleston SC if they come under investigation for what is known as ‘unbundling’. Unbundling refers to the process of billing for certain procedures separately when they should have been charged for as a bundle. There are a number of procedures that are bundled together in order to be more affordable for patients. Ungrouping these procedures to make a higher profit is indeed a form of fraud.
Think twice before making referrals
Does your husband or wife own a child psychology practice? Perhaps they are a qualified physiotherapist or dietitian? No matter how great they are at what they do, referring your patients to them is another form of healthcare fraud. This is because you have an indirect financial interest in their practice and so cannot be objective when recommending them in your professional capacity.
Another type of fraud when it comes to referrals is called ‘kickback referrals’. This is when you have been offered money or another incentive to promote a certain practice, company, or physician. Cover yourself by only ever referring patients to another company or individual that you know is qualified and that promises a high standard of care, and that is not related or tied to you in any way.
Taking action to keep your practice fraud-free is extremely imperative if you want to ensure its longevity and you are determined to build up a solid reputation among your patients. So, do your research and do not hesitate to consult with a lawyer if there is anything of which you are uncertain.
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